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Mesenchyma dystrophies.# On autopsy of the 58-year-old man it is revealed: mitral valve is deformed, thickened, not totally closed. Microscopically: centers of collagen fibers are eosinophilic, have positive fibrin reaction. The most likely it is: Hyalinosis Mucoid swelling @Fibrinoid swelling Amyloidosis Fibrinoid inflammation # The examination of skin biopsy of a patient with hemorrhage vasculitis revealed the next: the vessel wall was thickened, homogenous, stained in yellow colour by means of picrofuchsin, PAS-positive. What pathologic process has developed in the vessels walls? Mucoid swelling @ Fibrinoid swelling Amyloidosis Hyalinosis Lipidosis # The dissection of a 49 year old male reveals a deformed mitral valve, which is thickened and does not completely close. Microscopically the foci of the collagen fibers are eosinophilic and give a positive reaction on a fibrin test? The most credible explanation is: @Fibrinoid swelling Fibrinoid inflammation Mucoid swelling Hyalinosis Amyloidosis # A skin biopsy of a patient with allergic vasculitis was submitted for examination. It is discovered that the vessel walls were thickened and homogeneous. Picrofuxin stained a tissues a yellow color. They were Shiff-positive. Which pathological process developed in the walls of the vessels? @Fibrinoid swelling Amyloidosis Mucoid swelling Hyalinosis Lipidosis # Biopsy examination of skin of patient with allergic vasculitits showed: vessel side is thickened, homogenous, while staining with picrofuxin becomes yellow in colour. Schiff-iodine reaction is positive. Name the pathological process. Lipidosis Amyloidosis Mucoid swelling Hyalinosis @Fibrinoid swelling # A 66 years old patient, had peritonitis 10 years before the death. On the section, the capsules of the liver and the spleen from place to place are much thickened, consolidated, and translucent. What is the most possible diagnosis? Mucoid swellyng Necrosis @Hyalinosis Fibrinoid swellyng Amyloidosis # A 56 year old patient with a six year history of peritonitis has died. During dissection the capsule of the liver and the spleen was markedly thickened in places and was noted as being dense and semi-lucent. The most credible explanation for this is: @Hyalinosis Necrosis Mucoid swelling Fibrinoid swelling Amyloidosis # During the post-mortem performed on a 72 year old man there are noted some diminished areas of the spleen with a pinkish color. Microscopic examination revealed that the follicles are diminished in volume and the walls of the arterioles and trabeculas are thickened as well as containing homogeneous eosinophilic, PAS-positive masses. Staining with picrofuksin dye reveals the masses to be a red color. These changes indicate the presence of: @Hyalinosis Amyloidosis Mucoid swelling Fibrinoid swelling Sclerosis # Macroscopic examination of a stomach delivered from surgery, revealed a round lesion 1.5cm in diameter which extended by the muscle layer at the antral zone of a small curvature. A semilucent dense area on the bottom of the defect was also determined. It resembled hyaline cartilage. Which process developed in the bottom of the stomach lesion? @Localized hyalinosis Amyloidosis Mucoid swelling Fibrinoid changes Generalized hyalinosis # At autopsy a 76-year-old male, with a history of peritonitis 10 years ago, is found to have thickened and dense both liver and spleen capsules. They were translucent on a sectional view. What is the most likely pathology of the described organs capsules? @Hyalinosis. Necrosis. Mucoid swelling. Fibrinoid swelling. Amyloidosis. # Macroscopically: liver is enlarged, thickened, its tissue greyish-yellow colour with greasy shine. Name the pathological process. @Amyloidosis Hyalinosis Lipid dystrophy Mucoid swelling Haemochromatosis # An 87-year-old man develops worsening heart failure. Workup reveals decreased left ventricular filling due to decreased compliance of the left ventricle. Two months later the patients dies, and postmortem sections reveal deposits of eosinophilic, Congo red-positive material in the interstitium of his heart. When viewed under polarized light, this material displays an apple-green birefringence. Which of the following is the most likely diagnosis? @Amyloidosis Glycogenosis Hemochromatosis Sarcoidosis Senile atrophy # A 55-year-old female, with a long history of rheumatoid arthritis, develops renal failure and dies. An autopsy revealed an enlarged solid spleen. On the sectional view, its tissue had brown-reddish coloring with enlarged follicles that look like translucent grayish-white grains. What is the most likely pathological process? @Sago spleen. Frosted spleen. Lardaceous spleen. Spleen hyalinosis. Porphyry spleen. # The dissection of a 48 year old patient who suffered with rheumatoid arthritis reveals an enlarged, dense spleen. A spleen's section demonstrates its brown-reddish color with enlarged follicles which have the appearance of semi-lucent, grayish-white corns. What is the name of these lesions in the spleen? @Sago-like spleen. Glazed spleen. Sebaceous spleen. Hyalinosis of spleen. Porphyry spleen. # On autopsy of the 40-year-old woman suffering from rheumatic arthritis, the enlarged solid spleen was revealed. On section its tissue is of the mahogany color with enlarged follicles, which look like semi-transparent grayish-whitish grains. What pathological process is the most likely? Waxy spleen Glaze spleen Hyaline spleen Porphyric spleen @Sago spleen # During the section of the 40-year-old woman, who was ill with rheumatoid arthritis, an enlarged solid spleen was revealed. Its tissue is of brown-red color with enlarged follicles that look like translucent grayish-white corn. On what pathological process does the description indicate? @Sago spleen Shugar glazed spleen Diffuse waxy spleen Spleen hyalinosis Porphyry spleen # During dissection of a 65 year old patient, who suffered from a fibrous-cavernous tuberculosis, an enlarged, dense spleen was found. Spleen section grossly had brown-pinkish color, smooth, waxy-like surface. Which pathological process listed below is the most credible? @Sebaceous spleen. Glazed spleen. Porphyry spleen. Sago spleen. Cyanotic induration # A 66-year-old female, with a long history of post-traumatic osteomyelitis, is admitted to the hospital for treatment of nephrotic syndrome. On the night pf admission she suddenly dies. Autopsy revealed dense, white kidneys with scars in the cortical layer; they had a sebaceous glow on the cut surface. What is the most likely kidneys pathology? @Secondary amyloidosis. Primary amyloidosis. Idiopathic amyloidosis. Chronic glomerulonephritis. Chronic pyelonephritis. # The post-mortem of a patient revealed feature of chronic kidney insufficiency. Grossly, kidneys were enlarged, dense, and wax-like, with foci of irregular depressed scars on their surface. Microscopically, the mesangeal areas were expanded and the glomerular capillaries obstructed by Congo red stain-positive amorphous acellular material. In some sections the deposits took on nodular appearance. Which of the following diagnoses is most reliable? @Amyloidosis of the kidneys (Amyloid nephropathy) Acute glomerulonephritis Chronic glomerulonephritis Subacute glomerulonephritis Lipoid nephrosis # An autopsy of a 45-year-old female revealed the kidneys were dense, yellow in color and appears to have a greasy brilliance. Which pathological process is most likely? @Amyloidosis Hyalinosis Fatty dystrophy Mucoid swelling Hemochromatosis # A 56 year bid female has been ill with chronic fibrocavernous tuberculosis of the lungs for the past 20 years. She entered the nephrology department with a uremia syndrome. A test for the presence of amyloid in kidneys was positive. Which form of amyloid is indicated in this case? @Secondary Primary Localized Familial congenital Senile # An autopsy of a man, who suffered from bronchiectasia and died of chronic renal failure revealed enlarged kidneys of thick consistency, with thickened cortex of white colour and greasy shine. Name the disease. @Secondary amyloidosis Glomerulonephritis Chronic pyelonephritis Necrotic nephrosis Membranous nephropathy # A 40-year-old man during 10 years after the fracture of tibia had a chronic osteomyelitis. The patient had also nephritic syndrome 3 years before the death. Uremia caused his death. On section: kidneys are consolidated, white, with scars in cortex; they have waxy glow, on section. Determine the pathology that developed. Idiopathic amyloidosis Primary amyloidosis @Secondary amyloidosis Chronic glomerulonephritis Chronic pyelonephritis # A man suffered from chronic mandibular osteomielitis. Recent blood analysis: hypoproteinaemia, dysproteinaemia. Recent urine analysis: proteinuria, protein cylinders. Cause of death - chronic renal failure. What pathological process was revealed on section? @Amyloidosis Chronic glomerulonephritis Hydronephrosis Chronic pyelonephritis Interstitial nephritis # A 42 y.o. man who had been suffering from chronic granulomatous periodontitis and chronic purulent osteomyelitis of his lower jaw for 8 years died under conditions of acute renal insufficiency. What complication of purulent osteomyelitis was developed in kidneys? Adipose degeneration Atrophy Necrosis of epithelium of convoluted tubules @Amyloidosis Hyalinosis # A man, who suffered from chronic mandibular osteomielitis for a long time, died of renal failure. Section revealed big greasy kidneys. Name the process. @Renal amyloidosis Atherosclerotic nephrosclerosis Glomerulonephritis Necrotic nephrosis Primarily shrunken kidney # A 52 year old male died from a heart attack. At the time of dissection a symmetric type of severe obesity discovered. The rupture of the right ventriculum wall resulted in hemopericardium. Under epicardium an excessive fat tissue formation discovered. A microscopy of the sample showed the excecive growth of fatty tissue accompanied with atrophy of myocardial fibers. Which pathological process is most likely responsible for the patient's death? @Simple obesity of the heart. Fatty dystrophy of myocardium. Ischemic heart disease. Hypertension Acute myocardium infarct # During a section of a 45-year-old man, who died of a sudden heart failure, were determined: symmetrical type of obesity III stage, rupture of the right ventricle with haemopericardium; an excessive amount of fat under the epicardium. Microscopically: fatty tissue penetrates the myocardium with the atrophy of muscle fibers. What pathological process is the most possible? @Simple fatty heart Dystrophia adiposa cordis Cardiac ischemia Hypertonic disease Acute myocardial infarction # A morbidly obese 51-year-old woman dies from complications of heart disease. At autopsy, her heart weighs 600 gm (normal up to 300 gm) with all the chambers enlarged. Microscopically, there is increased fibrous connective tissue seen in the interstitium between myocardial fibers. The fibers are increased in size. Beneath the epicardium can be seen adipocytes interdigitating with the myocardial fibers. Which of the following terms best describes the presence of the adipocytes in her myocardium? Steatosis Lipid degeneration @Fatty infiltration Cholesterolosis Xanthomatosis # A post mortem performed on a 50 year old male who died of a heart attack indicated a symmetric type of obesity of the III degree with rupture of the walls of the right ventricle and hemopericardium. Under the epicardium surplus deposits of fat were found. Microscopically, fatty tissue from the epicardium was dispersed in the myocardium with an atrophy of the muscle fibers. Which process listed below is the most reliable? @Obesity the heart. Fatty dystrophy of myocardium. Acute infarct of myocardium. Ischemic heart disease. Hypertension. # A 55-year-old man, with a long history of a symmetrical type of severe obesity, developed acute heart insufficiency followed with lethal outcome. An autopsy revealed right ventricle wall burst with hemopericardium and excessive amount of fatty tissue under epicardium. Microscopically: adipose tissue from epicardium penetrates myocardium with muscle fibers atrophy. Name the pathological process? @Simple fatty heart. Fatty degeneration of myocardium. Ischemic disease. Essential hypertension. Acute myocardial infarction. # In 45-year-old patient died from sudden cardiac death the symmetrical type of adipose heart of third degree; the rupture of right ventricle’s wall with hemopericardium and redundant accumulation of fat under epicardium were found out in autopsy. Microscopically: the adipose tissue grows from epicardium into myocardium with atrophy of fibers of muscle. What process is more probable? Acute myocardial infarction Ischemic heart disease Fatty degeneration of myocardium @Adipose heart Hypertensive disease # All following statement is associated with cholesterol accumulation EXCEPT one: Increase cholesterol blood level may leads to atherosclerosis Cholesterol may accumulates within cells or extracellular space Xantomas is the reflection of cholesterol-feeling cell aggregation within dermis Crystals of cholesterol may encountered in necrotic debris @With atherosclerosis cholesterol accumulates within endothelial cells of intima # Autopsy of a man ill with severe hypothyroidism revealed that connective tissue, organ stroma, adipose and cartilaginous tissues were swollen, semitransparent, mucus-lik E. Microscopic examination of tissues revealed stellate cells having processes with mucus between them. What type of dystrophy is it? Parenchymatous adipose @Stromal-vascular carbohydrate Parenchymatous proteinaceous Stromal-vascular adipose Stromal-vascular proteinaceous # A child has physical and mental retardation, serious abnormalities in connective tissue of internal organs; urine contains keratan sulfates. This is caused by metabolic disorder of the following substance: Fibronectin Hyaluronic acid @Glycosaminoglycan Elastin Collagen # Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case? Lymphatic vessels Parenchymatous elements of the organ Nerve elements Vessels of microcircular stream @ Intercellular substance # Mixed dystrophies. # Autopsy of a man who had been working as a miner for many years and died from cardiopulmonary decompensation revealed that his lungs were airless, sclerosed, their apexex had emphysematous changes, the lung surface was greyish-black, and the incised lung tissue was coal-black. What disease caused death? @Anthracosis Silicosis Aluminosis Asbestosis Talcosis # The autopsy of the man's body, that was working for a long time as a miner and died beacuse of chronic pulmonary-cardiac insufficiency, revealed that lungs were not in their ful volume, significantly thickened, sclerotic, the apexis were emphysematously changed, the surface was gray-black in colour, on section the lung tissue was aspid-black in colour. What disease caused the death? Asbestosis @ Anthracosis Aluminosis Silicosis Talcosis # A man had worked in a coal mine for over 20 years. After his death autopsy revealed that his lungs were dense, grayish-black and had large areas of neogenic connective tissue containing a lot of microphages with black pigment in the cytoplasm. What is the most likely diagnosis? @Anthracosis Anthracosilicosis Silicoanthracosis Talcosis Siderosis # While performing a pneumonectomy for a squamous cell carcinoma diagnosed in the right lung of a 54-year-old man, the thoracic surgeon notes that the hilar lymph nodes are small, 0.5 to 1.0 cm in size, and jet black in color throughout. You would describe these lymph nodes as having: @Anthracotic pigmentation Lipochrome deposition Accumulation of melanin Hemosiderosis Metastatic carcinoma # A54-year-old man with a chronic cough has a squamous cell carcinoma diagnosed in his right lung. While performing a pneumonectomy, the thoracic surgeon notes that the hilar lymph nodes are small, 0.5 to 1.0 cm in size, and jet black in color throughout. Which of the following is the most likely cause for this appearance to the hilar nodes? @Anthracotic pigmentation Lipochrome deposition Accumulation of melanin Hemosiderosis Metastatic carcinoma # An autopsy is performed on a 64-year-old man who died of congestive heart failure. Sections of the liver reveal yellow-brown granules in the cytoplasm of most of the hepatocytes. Which of the following stains would be most useful to demonstrate with positive staining that these yellow-brown cytoplasmic granules are in fact composed of hemosiderin (iron)? Oil red O stain Periodic acid-Schiff stain @Prussian blue stain Sudan black B stain Trichrome stain # Sputum analysis of a patient with mitral cardiac disease showed cells with brown pigment. Pearl's reaction is positive. What pigment is it? @Haemosiderin Haematoidin Melanin Porphyrin Bilirubin # A patient with a mitral valvular disease has a cough with a rusty phlegm. What pigment has determined the color? Haemoglobin Melanin @Haemosiderin Haemomelanin Ferum sulphite # A patient with mitral cardiac disease suddenly occurred cough. Sputum has rusty colour. What pigment caused this? @Haemosiderin Melanin Haemoglobin Haemomelanin Iron sulphide # The cells with a brown pigment were determined in patient’s phlegm, who had a mitral valve disease. The Perls’ test is positive. What pigment was mentioned? Bilirubin Haematoidin Melanin Porphyrin @Haemosiderin # While in a home improvement center warehouse buying paint, a 35-year-old man hears "Look out below!" and is then struck on the leg by a falling pallet rack, which strikes him on his left leg in the region of his thigh. The skin is not broken. The yellow-brown color of the 5 x 7-cm bruise to his thigh a couple of weeks after this injury are due to the accumulation of: Lipofuscin Bilirubin Melanin @Hemosiderin Glycogen # A 12-year-old boy with hemophilia A has decreased levels of coagulation factor VIII activity. He has pain about his knees. Over time, there is an increase in size of the knee joints with deformity. Which of the following materials is most likely to be seen within the joint space following episodes of pain: Lipofuscin Russell bodies Neutrophils Cholesterol crystals @Hemosiderin # A 22-year-old woman has a congenital anemia. She has required multiple transfusions of red blood cells for many years. She now has no significant findings on physical examination. Laboratory studies now show a serum AST of 74 U/L and ALT 75 U/L with albumin 3.6 g/dL. Which of the following microscopic findings would most likely appear in a liver biopsy? Steatosis in hepatocytes Bilirubin in canaliculi @Hemosiderin in hepatocytes Glycogen in hepatocytes Amyloid in portal triads # A 36-year-old man presents because his skin has been darkening recently. You notice that his skin has dark, somewhat bronze color. Work-up reveals signs of diabetes mellitus. His serum iron is found to be 1150mg/dL, and his transferring saturation is 98%. A liver biopsy is performed and reveals extensive deposits of hemosiderin in the hepatocytes and Kupffer cells. Which of the following basic abnormalities is the most likely cause of this constellation of clinical findings? Defective excretion of copper into the bile Defective synthesis of α1 antitrypsin Defective synthesis of glycogen Excessive absorption of galactose from the small intestines @Excessive reabsorption of iron from the small intestines # A man with insufficiency of the mitral valve complained of a cough and sputum with a brownish colouring. Which pigment results in this color of the sputum? @Hemosiderin Melanin Hemoglobin Hemomelanin Iron sulfate # The post-mortem of a man who presented in the hospital with a history of snakebite reveals expressed intravessels hemolysis. During dissection it is noted that the spleen, bone marrow and lymphatic nodes had a brown colouring. Microscopic examination showed that the cytoplasm of macrophages got a brown pigment. Which pigment accumulated in the tissues? @Hemosiderin Hematoidin Hematin Lipofuscin Bilirubin. # A 58-year-old male has been ill for many years with leukemia. A post-mortem exposed a brown color in the marrow, spleen, liver, and lymphatic nodes. The Perls' histochemical reaction was conducted. It was determined that the reticular, the endothelial cells and histiocytes of these organs contained granules of a dark blue color. Which pigment is responsible for the colouring? @Hemosiderin Bilirubin Hematoidin Hemomelanin Hematoporphyrin # A 56 year old patient died from chronic cardiac insufficiency as a result of rheumatic heart-disease. A post-mortem revealed that lungs were enlarged, dense with red-brownish coloring. What is the most likely diagnosis? @Brown induration lungs Acute bronchitis Honey-comb lungs Chronic bronchitis Chronic emphysema # A 65-year man died of chronic cardiac failure. Autopsy: brown-coloured due to rheumatic cardiac disease, enlarged and thickened lungs. What's the name for such lung changes? @Brown lung induration Nutmeg lungs Cell lungs Chronic bronchitis Chronic # A patient with mitral valve insufficiency presents in his sputum cells, filled with brown pigment. The Perls' reaction is positive. Name this pigment. @Hemosiderin Hematoidin Melanin Porphyrin Bilirubin # True statement regarding hemachromatosis include all the following EXCEPT It characteristically causes a micronodular pigment cirrhosis It is complicated by carcinoma of the liver in 15 to 30 percent of cases with cirrhosis It causes diabetes with severity unrelated to the degree of pancreatic iron deposition It can be diagnosed by liver biopsy showing raised amounts of hemosiderin @It is associated with skin pigmentation due entirely to deposition of hemosiderin # A patient developed a cyst in the cerebrum following a hemorrhagic stroke. Two years later the patient died from pneumonia due to a complication of influenza. During examination of the brain cyst it is noted that the walls have a rusty tint. Perls' reaction is positive. Name the process occurring in the wall of the cyst? @Localized hemosiderosis General hemosiderosis Local hemomelanosis Infiltration of bilirubin Primary haemochromatosis # A post-mortem of a 44-year-old patient with a history of mitral stenosis reveals dense lungs that are a brown color. Which pathological process is most likely in the lungs? @Hemosiderosis Hemochromatosis Icterus Heme-melanosis Lipofuscinosis # An autopsy of a man, who suffered from mitral stenosis, showed thickened lungs of brown colour. What pathological process is described? @Haemosiderosis Haemochromatosis Jaundice Haemomelanosis Lipofuscinosis # A 45-year-old male, with a long history of rheumatism and mitral valve insufficiency, develops a chronic cough with rusty expectoration. What pigment colored sputum? @Hemosiderin. Melanin. Hemoglobin. Malarial pigment. Iron sulfide. # A 67-year-old man, with a long history of mitral valve's insufficiency, has been experiencing a cough with red-brownish coloring of sputum. Cells with brown pigmentation and positive Perls' test were detected in the sputum. Which pigment responsible for the septum coloring? @Hemosiderin. Hematoidin. Melanin. Porphyrin. Bilirubin. # In newborn on the 5th day of life the hypertermia and seizures are observed. Child flaccid, reflexes are lowering. Skin and mucoses are yellow. Blood level of indirect bilirubin is 65.5 mcmol/l. What is more dangerous in this state? @Kernicterus (nuclear jaundice) Nephrotoxicity of bilirubin Anemia Accumulation of products of hemolysis This is physiologic jaundice (not dangerous) # 28 In newborn on the 3rd day of life skin and mucoses became slightly yellow. Blood level of direct bilirubin is 5.0 mcmol/l, indirect bilirubin is 30.5 mcmol/l. What diagnosis is it possible to think about? @Physiologic (neonatal) jaundice Kernicterus (nuclear jaundice) Toxic hepatitis Parenchymatous jaundice Obstructive jaundice # Blood analysis of a patient’s ill with jaundice revealed increase of total bilirubin by its indirect fraction. Urine and feces are intensively stained. What is the most probable mechanism of these abnormalities? Damage of liver parenchyma Obstructed bile outflow from the liver Disturbed conversion of urobilinogen in liver @Increased erythrocyte hemolysis Disturbed formation of direct bilirubin # In newborn on the 3rd day of life the skin and mucoses are yellow. Blood level of direct bilirubin is 4.5 mcmol/l, indirect bilirubin – 65.5 mcmol/l. This state is the result of what process? @Hemolysis of erythrocytes Obstruction of bile ways Fructose intolerance Parenchymatose jaundice Toxic hepatitis # A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood plasma the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in urine. What type of jaundice is it? Gilbert's disease Obturational Cholestatic Parenchymatous @Haemolytic # Blood analysis of a patient’s suffering from jaundice revealed increase of total bilirubin by its indirect fraction. Urine and feces have intense colouring. What is the most probable mechanism of these abnormalities? Obstruction of bile outflow from the liver Impaired transformation of urobilinogen in the liver Damage of liver parenchyma Impaired generation of direct bilirubin @Increased haemolysis of erythrocytes # Enzymatic jaundices are characterized by disbalanced activity of UDP-glucuronyl transferase. What compound is accumulated in the blood serum in case of these pathologies? Biliverdin @Indirect bilirubin Verdoglobin Direct bilirubin Mesobilirubin # Young woman after snake’s bite has developed the picture of hemolysis. The jaundice of the skin, scleres and mucous membranes are detected. These symptoms are caused by bilirubin accumulation. What type bilirubin is accumulated in the blood? @Indirect bilirubin Direct bilirubin Indirect and direct bilirubin Ferritine Haemomelanine # A 52-year-old male with a history of sub-acute septic endocarditis is examined by a physician. A doctor revealed marked general pallor with icteric skin, sclera and visible mucous membranes. Blood test showed accumulation of indirect reacting bilirubin (unconjugated bilirubin). The yellow staining of the skin, sclera and mucous membranes indicates which one of the following? @Prehepatic jaundice Fatty dystrophy Hemosiderosis Hepatic jaundice Posthepatic jaundice # All following disorders lead to the haemolytic jaundice EXCEPT one: Sepsis Isoimmune conflict Talassemias Malaria @Arterial hypertension # A full-term normal male infant develops a slight yellow color to his skin on his second day of life. Laboratory examination finds his serum bilirubin levels to be slightly elevated (due to increased indirect bilirubin), but the levels are less than 6mg/dL. Additionally, serum hemoglobin levels are within normal limits. By the fifth day his bilirubin levels have returned to normal levels and abnormal yellow skin color has disappreared. No therapy was given to this infant. Which of the following is the most likely cause of these signs and symptoms? Crigler-Najjar syndrome Hemolytic disease of the newborn Inspissated bile syndrome Intrauterine varicella infection @Physiologic jaundice of the newborn # 38 Pre-hepatic (hemolytic) jaundice takes place in all the following cases besides the only one of them: @Viral hepatitis Sepsis Malaria Hemolytic disease of newborns Relapsing fever # A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have strengthened concentration in the blood serum? Biliverdin @Unconjugated bilirubin Verdoglobin Mesobilirubin Conjugated bilirubin # A 12-year-old boy with sickle cell anemia presents with recurrent severe right upper quadrant colicky abdominal pain. At the time of surgery, multiple dark black stone are found within the gallbladder. These stones are composed of which one of the following substances? @Bilirubin Carbon Cholesterol Struvite Urate # A 54-year-old man presents with a high fever, jaundice, and colicky abdominal pain in the right upper quadrant. The gallbladder cannot be palpated on physical examination. Work-up reveals hemoglobin level of 15.3g/dL, unconjugated bilirubin level of 0.9mg/dL, conjugated bilirubin level of 1.1 mg/dL, and alkaline phosphatase level of 180 IU/L. which of the following is the most likely diagnosis? Acute cholecystitis Chronic cholecystitis @Bile duct obstruction by a stone Carcinoma of the gallbladder Carcinoma of the head of the pancreas # According to Courvoisier’s law, a pancreatic cancer located in the head of the pancreas should be suspected in an individual with which one of the following clinical signs? Migratory thrombophlebitis @Obstructive jaundice and a dilated gallbladder Obstructive jaundice and a nonpalpable gallbladder Steartorrhea and a nontender gallbladder Steartorrhea and a tender gallbladder # The patient is admitted to a hospital with hyperthermia and complaints of weakness, loss of appetite, and yellow color of skin, lighter than usually color of feces. Blood level of indirect is 28.5 mmol/l, direct bilirubin – 20.5mmol/l. What additional investigation is the most important for diagnosis? @Urobilinogen in urine Tercobilin in feces Hemoglobin in blood Bilirubin in urine Alkaline phosphatase in blood # A patient with apparent icteritiousness of skin, sclera and mucous membranes was admitted to the hospital. The patient's urine was of brown ale colour, analysis revealed presence of direct bilirubin. Feces had low concentration of bile pigments. What type of jaundice is it? Parenchymatous @Obturative Haemolytic Conjugated Absorbtion # A patient ill with jaundice has increased content of conjugated bilirubin and bile acids in blood, no stercobilinogen in urine. What jaundice are these symptomps typical for? Cythemolytic Hepatic Hemolytic Hepatocellular @Obstructive # A 48-year-old patient was admitted to the hospital with complaints about weakness, irritability, sleep disturbance. Objectively: skin and scleras are of yellow colour. In blood: increased concentration of total bilirubin with prevailing direct bilirubin. The feces are acholi c. The urine is dark (contains bile pigments). What type of jaundice is it? Gilbert's syndrome Crigler-Najjar syndrome @Mechanic Parenchymatous Haemolytic # On patient's gastroscopy was detected gastric ulcer of the mucous membrane with stamped edges and brown-black base, and on gastrobiopsy acute ulcer is confirmed with brown-black pigment in its necrotic layer. What is the pigment? @Hydrocloride hematin Hemosiderine Bilirubin Ferritin Porphirin # A fluid of coffee grounds color was endoscopically determined in a patient who had ulcerative disease of the stomach with bleeding. What pigment does determine the color? Haemosiderin @Haematin chloride Bilirubin Ferritin Porphyrin # A 46-year-old man has an acute stomach ulcer complicated by gastric bleeding and vomiting. Gastric masses had a brown color and "coffee-like" appearance. Which pigment created such colouring? @Hematin hydrochloride Hemoglobin Bilirubin Hemomelanin Iron sulfide # A patient with acute peptic ulcer and haemorrhage has vomit of brown, coffee-like colour. What pigment defines the colour? @Haematin chloride Haemoglobin Bilirubin Haemomelanin Iron sulphide # An endoscopy of a patient with peptic ulcer and haemorrhage showed coffee-like liquid. What pigment coloured the gaster content? @Haematin chloride Haemosiderin Bilirubin Ferritin Porphyrin # A 38-year-old female with chronic stomach ulcer complicated with bleeding examined endoscopically. Stomach masses had coffee ground coloring. Which pigment responsible for this coloring? @Hematin chloride. Hemosiderin. Bilirubin. Ferritin. Porphyrin. # An endoscopy was performed on a patient with a chronic stomach ulcer complicated with hemorrhage. This procedure revealed a brownish (coffee-like) liquid in the stomach. Which pigment results in the color of the stomach contents? @Hematin hydrochloride Hemosiderin Bilirubin Ferritin Porphyrin # During post-mortem of a patient arrived from a tropical country, it is discovered that there is a hemomelanosis of a liver, spleen and elements of the reticuloendothelial stroma. These changes are characteristic for which disease? @Malaria Dysentery Diabetes mellitus Exanthematic typhus Grippe # The post-mortem of a patient who suffered from malaria revealed jaundiced skin, sclera and mucous membranes. Also, the spleen was enlarged and had dark-grey color. This colour of the spleen is due to the presence of: @Hemomelanin Hemosiderin Lipofuscin Melanin Hemoporphyrin # A post-mortem was performed on a 55-year-old male, who over last eight years suffered from chronic form of malaria. At the dissection both grey matter of the cerebrum and a spleen had the ash- grey color. Which pigment is responsible for this discoloration? @Hemomelanin Lipofuscin Hematoporphyrin Melanin Hemosiderin # An autopsy of 55-year old man, who suffered from chronic tropical malaria revealed grey brain substance and spleen of greyish colour. What pigment caused this? Haemosiderin Lipofuscin Haematoporphyrin Melanin @Haemomelanin # Patient experienced increased susceptibility of the skin to the sunlight. His urine after some time became dark-red. What is the most likely cause of this? Pellagra Alkaptonuria @Porphyria Albinism Hemolytic jaundice # A patient has high sunlight sensitivity of skin. During standing his urine turns dark-brown. What is the most probable cause of this condition? Pellagra Albinism Haemolytic jaundice Alkaptonuria @Porphyria # A patient, who suffers from congenital erythropoietic porphyria, has skin photosensitivity. The accumulation of which compound in the skin can cause it? Coproporphyrinogen 3 Protoporphyrin @ Uroporphyrinogen 1 Uroporphyrinogen 2 Heme # A mother consulted a doctor about her 5-year-old child who develops erythemas, vesicular rash and skin itch under the influence of sun. Laboratory studies revealed decreased iron concentration in the blood serum, increased uroporphyrinogen I excretion with the urine. What is the most likely inherited pathology in this child? Methemoglobinemia Coproporphyria @Erythropoietic porphyria Hepatic porphyria Intermittent porphyria # A 29-year-old man goes on a snorkeling trip to Looe Key Marine Sanctuary and later spends time on the beach at Bahia Honda State Park. The next day he has adarker complexion. His skin does not show warmth, erythema, or tenderness. His skin tone fades to its original appearance within a month. Which of the following substances contributes the most to the biochemical process leading to these skin changes? Heme Lipofuscin @Tyrosine Homogentisic acid Glycogen # Which of the following pigments is derived from thyrosin: Lipofuscin @Melanin Hemosiderin Bilirubin Ferritin # In the bit of the skin 1x2 cm, which was delivered for hystologic examination, brown-coloured formation 0,5 cm in diameter is found, Microscopically formation consists of nevus cells streak- and nestlike, located in the derma with brown pigment in the cytoplasm, which gives negative Perl's reaction. What pigment is the most probable? @Melanin Hemosiderin Bilirubin Hemomelanin Hematoidine # The skin of a patient with bilateral affliction of adrenal glands became dark brown. The Perls’ test is negative. What pigment determines the color of the skin? @Melanin Haemosiderin Porphyrin Lipofuscin Biliverdin # A patient with bilateral adrenal gland failure gained dark-brown skin colour. Histochemical research of skin showed Pearl's reaction negative. What pigment causes such skin colour? @Melanin Haemosiderin Porphyrin Lipofucsin Biliverdin # Nappies of a newborn have dark spots that witness of formation of homogentisic acid. Metabolic imbalance of which substance is it connected with? Galactose Cholesterine Methionine @Thyrosine Tryptophane # A patient with a long history of tuberculosis was examined at the hospital. Physical examination revealed a grayish-brown skin color, lowered arterial pressure, hypodynamia and a decline of the level of 17-oxycorticosteroids in the urine and blood plasma. A problem with the metabolism of which pigment is indicated by the clinical signs of this patient? @ Melanin Bilirubin Lipofuscin Lipochrome Hemosiderin # A fragment of skin (1x2 centimeters) delivered for histological research. Grossly a small (0,5 cm in diameter) slightly elevated brown lesion, sharply demarcated from the surrounding normal skin, was recognized. Microscopically, a lesion presented with nevus cells nests, rich with brown pigment. This pigment had negative Perls' reaction. Name the pigment. @Melanin Hematoidin Hemosiderin Bilirubin Hemomelanin # A 55-year-old patient with bilateral adrenal glands lesions presented with dark brown colouring of the skin. During histochemical examination of the skin the Perls' reaction was negative. Which pigment is responsible for this discoloration of the skin? @ Melanin Hemosiderin Porphyrin Lipofuscin Biliverdin # A 38-year old female is found to have bilateral adrenal adenopathy resulted in brownish coloring of her skin. Perls' test of her skin's biopsy was negative. What pigment altered the color of the skin? @Melanin. Hemosiderin. Porphyrin. Lipofuscin. Biliverdin. # Metabolism of which of the following pigments is disturbing due to Addison's disease: Lipofuscin @Melanin Hemosiderin Bilirubin Ferritin # A 66-year-old male, with a history of hematogenic tuberculosis was examined. This revealed hyperpigmentation of skin and mucous membranes, cachexia and insufficiency of the cardio-vascular system. Which disease caused such changes? @Addison's disease Phaeochromocytoma Simmond's disease Cushing disease Grèves' disease # A 47-year-old male, with a history of secondary syphilis, has noticed foci of the skin depigmentation at his neck. Name the pathological process of the skin. @Leukoderma. Metaplasia. Leukoplakia. Dysplasia. Parakeratosis. # A patient with a secondary syphilis presents with skin focal depigmentation in the upper part of the back. Name the pathological process of the skin. Dysplasia Metaplasia Leucoplakia @Leucoderma Parakeratosis # The light brown perinuclear pigment seen on H&E staining of the cardiac muscle fibers in the grossly normal appearing heart of an 80-year-old man at autopsy is: Hemosiderin resulting from iron overload @Lipochrome from "wear and tear" Glycogen resulting from a storage disease Cholesterol as a consequenceof atherosclerosis Calcium deposition followingnecrosis # An autopsy of a patient, who died of chronic sepsis, revealed atrophy of skeletal muscles, brown myocardial and liver dystrophy. What pigment metabolism is failed? @Lipofuscin Lipochrome Haemosiderin Haemomelanin Melanin # A man died from chronic sepsis. A post-mortem revealed an atrophy of the skeletal muscles and brown atrophy of both myocardium and liver. Which one of the following pigments accumulated in tissues? @Lipofuscin Lipochrome Hemosiderin Hemomelanin Melanin # A 62-year-old female with a history of stomach cancer with plural metastases died from a cachexia. Select the characteristic changes of the heart expected to be revealed on dissection. @Brown atrophy of myocardium. Amyloid cardiomegaly. Dilatation cardiomyopathy. Hypertrophy cardiomyopathy. "Tabby cat" ("Tiger's heart"). # An 80-year-old man dies from complications of Alzheimer disease. At autopsy, his heart is small (250 gm) and dark brown on sectioning. Microscopically, there is light brown perinuclear pigment with H&Estaining of the cardiac muscle fibers. Which of the following substances is most likely increased in the myocardial fibers to produce this appearance of his heart? Hemosiderin resulting from iron overload @Lipochrome from "wear and tear" Glycogen resulting from astorage disease Cholesterol as aconsequence of atherosclerosis Calcium deposition following necrosis # A 90-year-old woman dies from pneumonia complicating Parkinson disease. At autopsy her heart is normal in size. On microscopic examination, there is increased lipochrome (lipofuscin) seen adjacent to the nuclei within the myocardial fibers. This microscopic finding is most likely to result from which of the following cellular mechanisms? Nuclear pyknosis Myocardial fiber hypertrophy Coagulative necrosis @Autophagocytosis Anaerobic glycolysis # At autopsy 68-year-old male is found to have cancer of the esophagus, accompanied with cachexia. Grossly, fatty tissue disappeared; both a liver and a heart were atrophic. Microscopy revealed brown- yellowish corn-like deposited next to nuclei of myocardial cells. These accumulations had negative Perls' reaction. Name the material of accumulations. @ Lipofuscin Melanin Hemosiderin Ferritin Hemomelanin # A 90-year-old woman dies from pneumonia complicating Parkinson disease. At autopsy her heart is normal in size. On microscopic examination, there is increased lipochrome (lipofuscin) seen adjacent to the nuclei within the myocardial fibers. This microscopic finding is most likely to result from which of the following cellular mechanisms? Nuclear pyknosis Myocardial fiber hypertrophy Coagulative necrosis @Autophagocytosis Anaerobic glycolysis # A 70-year old man complains about pain in small joints both in upper and lower extremities. Joints are deformed, painful. There is an increased level of urates in blood and urine. The metabolism of what substances is failed? Calcium @Nucleoproteides Chromoproteins Lipoproteins Potassium # A patient has increased content of uric acid in his blood that is clinically presented by pain syndrome as a result of urate deposition in the joints. What process does this acid result from? Reutilization of purine bases @Lysis of purine nucleotides Heme catabolism Proteolysis Lysis of pyrimidine nucleotides # A 45-year-old man presents with severe pain in both knee joints. At the time of surgery, his cartilage is found to have a dark blue-black color. Further evaluation reveals that the patient’s urine has darkened rapidly with time. Which of the following is most likely diagnosis? Hyperphenylalaninemia Tyrosinemia Tyrosinase-positive oculocutaneous albinism @Alkaptonuria Maple syrup urine disease # A 70-year-old man complains of the articular pains in his hands and feet. Joints are alterated, painful. An elevated level of urates in blood and urine was determined. The metabolic disturbance of what substances is meant? Potassium Calcium Chromoproteins Lipoproteins @Nucleoproteins # A patient has increased contents of uric acid in his blood, what is clinically manifested by pain syndrome due to accumulation of urates in his joints. What process does the formation of this acid result from? Purine bases re-using Proteolysis @ Purine nucleotide decay Heme catabolism Pyrimidine nucleotide decay # A 65-year-old suffering from the gout man complains of the pain in the kidney's region. On ultrasonic examination the renal calculi were revealed. As a result of what process were they formed? Ornithine cycle Protein catabolism Heme decay Restoration of cysteine @Decay of purine nucleotides # A 66-year-old patient complained of pain in the hands and feet joints. Physical examination revealed a deformation and painful of the joints. Laboratory tests showed the increased level of uric acid salts in the blood and urine. Which one of following is not being fully metabolized? @Nucleoprotein. Calcium. Chromoprotein. Lipoprotein. Potassium. # A 70-year-old man has noticed recent swelling of joints of his hands and feet. Joints are painful and stiff. Laboratory tests revealed an increased level of urates in blood and urine. What is the most likely substance caused described pathology? @Nucleoproteins. Calcium. Chromoproteids. Lipoproteins. Potassium. # A man 65 years old, who has suffered by gout, has been complaining on the pain in the kidney region.There are renal calculus on the ultrasound diagnosis. What substance is the most probably cause of the calculus forming? @Owing to uric acid Owing to bilirubin Owing to oxalate Owing to phosphate Owing to cholecterol # The patient, 55 years old, is admitted to a hospital with a joint pain syndrome. During examination the contents of uric acid in the blood was 2.1 mmol/l, in the urine 0,066 g/l of protein and blood were found, deposits of lithates in joints and kidney were detected. The cause of such state can be: @podagra (gout) phenylketonuria branched chain aminoaciduria (maple syrup disease) alkaptonuria Hartnup’s disease # A 54-year-old man present with chronic knee pain. Resection of the patella reveals chalky white deposits on the surface of intraarticular structures. Histologic sections reveal long, needle-shaped, negatively birefringent crystals. The photomicrograph below was taken under polarized light. These finding are most consistent with a diagnosis of Osteoarthritis Rheumatoid arthritis Ochronosis @Gout Pseudogout # Secondary gout may be seen in association with all the following EXCEPT Polycytemia Psoriasis Hemolytic anemias Myeloprolyferative disease @Chonddrocalcinosis # An animal with aortic valve insufficiency got hypertrophy of its left heart ventricl E. Some of its parts have local contractures. What substance accumulated in the myocardiocytes caused these contractures? Sodium Carbon dioxide Lactic acid @Calcium Potassium # Periodic renal colics attacks are observed in a woman with primery hyperparathyroidizm. Ultrasonic examination revealed small stones in the kidneys. What is the most plausible reason of the stones's formation? Hyperphosphatemia @Hypercalcemia Hypercholesterinemia Hyperuricemia Hyperkalemia # All following states are associatedwith hypercalciemia EXCEPT one: Tumour of parathyroid glands @Tumour of thyroid gland Multiple bones fractures Chronic renal failure Vitamin D intoxication # During the section of a died woman who had chronic shigellosis, there were found amorphous deposits of violet color in myocardial, renal stroma and parenchyma, in the mucous membrane of the stomach and in the connective tissue of lungs. The Koss’ reaction is positive. What pathological process had developed? Metabolic calcification Dystrophic calcification @Metastatic calcification Amyloidosis Hyalinosis # A 58-year-old female with a long history of chronic dysentery died. At autopsy, the stroma and parenchyma of the myocardium, kidneys, the mucous membrane of the stomach, and the connective tissue of lungs revealed violet color amorphous masses, which had positive Koss' reaction. Which pathological process developed in the patient's organs? @ Metastatic calcification Dystrophy calcification Metabolic calcification Amyloidosis Hyalinosis # The dissection of a patient who suffered from rheumatism and chronic rheumatic valvulitis revealed that mitral valve leaflet was thickened with rough stony deposits. Name the pathology presented with stony appearance of the valves? @Dystrophy calcification Metastatic calcification Metabolic calcification. Fibrinoid Amyloidosis. # A 38-year-old woman presents with intermittent pelvic pain. Physical examination reveals a 3-cm mass in the area of her right ovary. Histologic sections from this ovarian mass reveal a papillary tumor with multiple, scattered small, round, and laminated calcifications. Which of the following is the basic defect producing these abnormal structures? Bacterial infection @Dystrophic calcification Enzymatic necrosis Metastatic calcification Viral infection # A 38-year-old man has a health screening examination. He has a routine chest x-ray that shows a 2 cm nodule in the right lower lobe. The nodule has focal calcifications. A wedge resection of the nodule is done. On microscopic examination the nodule shows caseous necrosis and calcification. Which of the following processes explains the appearance of the calcium deposition: @Dystrophic calcification Apoptosis Hypercalcemia Metastatic calcification Excessive ingestion of calcium # On the autopsy of the woman body 63 years old, who suffered from rheumatism, combine mitral valvular disease. Cusps of the mitral valve are fibrotic, thick, irregular,calcified,adhere together, on the cut crunching is detected. What pathological process is the cause of the stony density of the heart valves? @Distrophic calcification Amyloidosis Hyalinosis Metabolic calcification Metastatic calcification # The best example of dystrophic calcification is seen in a (an): 55-year-old woman with metastases from breast carcinoma and hypercalcemia @Healing granuloma in a 41-year-old man with pulmonary tuberculosis Gangrenous lower extremity in a 50-year-old woman with diabetes mellitus 62-year-old woman with a recent cerebral infarction Abscess of the left fallopian tube ina 19-year-old woman with Neisseria gonorrheae infection # A 38-year-old man has a chest x-ray that shows a 2-cm nodule in the right lower lobe. The nodule has focal calcifications. A wedge resection is done and microscopically the lesion proves to be a granuloma with caseous necrosis and calcification. Which of the following processes explains the appearance of the calcium deposition; @Dystrophic calcification Apoptosis Hypercalcemia Metastatic calcification Excessive ingestion of calcium # A clinical study is performed in which the conditions leading to the apperance of calcification on chest and abdominal CT scans are analyzed in patients from 60 to 90 years of age. One set of patients is found in which the finding of calcification was incidental, with no serious health problems. In which of the following tissue locations was this incidental calcification most likely to be noted? Coronary artery Renal cortex Aortic valve @Pulmonary parenchyma Aortic arch # In which of the following patients would the presence of calcification is LEAST harmful: A 55-year-old man undergoing coronary artery angioplasty Nephrocalcinosis in a 60-year-old woman with hyperparathyroidism Aortic valvular calcification in a 70-year-old man @Alveolar wall calcification in a 41-year-old woman with breast cancer metastatic to bone Aortic arch calcification in a 62-year-old man # A patient suffering from hepatocerebral degeneration has low cncentration of ceruloplasmin in blood serum. What element accumulation will be observed in liver, cerebrum and kidneys of the patient? Potassium @Cuprum Calcium Sodium Ferrum # Complaints and objective data allow to suggest that a patient has inflammation in his gallblader, bile colloidoclasia, probability of gallstones formation. What can be the main cause of gallstones formation? Oxolates Chlorides @Cholesterol Urates Phosphates # Man, 52 years old, is admitted to a hospital with a joint pain syndrome. During examination the contents of uric acid in the blood was 3.0 mmol/l, in the urine protein and blood were found, deposits in joints were detected. What can be found during X-ray examination (excretory urography) of kidney in this patient? @Lithates Oxalates Cancer of kidney Absence of kidney Examination of kidney is not necessary in this patient # Necrosis # A 30-year-old woman present with malaise and increasing fatigue. Physical examination finds a yellow-tinge to her skin and sclera, and laboratory evaluation finds elevated serum liver enzymes. After further work-up, the diagnosis of viral hepatitis is made. This work-up included a liver biopsy, which revealed scattered, eosinophilic cells (Councilman Bodies), but very little inflammation was present. These Councilman Bodies were formed by an active process that characteristically lacks an inflammatory response and results from the activation of genes that forms new enzymes, such as endonucleases. These enzymes subsequently destroy the cell itself. Which of the following terms best describes this process? @Apoptosis Autophagy Heterophagi Metaplasia Necrosis # The investigation of the liver's biopsy revealed that some separately arranged cells burn on small- sized pieces surrounded by a membrane. In some of them there were organelles, other had the fragments of dissolved nuclei. The inflammatory reaction around these cells missed. Name these changes: @Apoptosis Atrophy Necrosis Hypoplasia Dystrophy # Histological investigation of liver's biopsy revealed that some cells burn on small pieces with separate organellas and nuclei fragments surrounded by a membrane. The inflammatory reaction was missing. Select pathological process, the described changes are characteristic for: @Apoptosis Necrosis Karyorrhexis Plasmolysis Plasmorrhexis # An ultrastructural examination of a salivary gland revealed within cells pieces of the nuclei surrounded by a membrane. Also condensate fragments of nuclear material and separate organelles were found. An inflammatory reaction around these cells was missing. Which term most correctly defines these alterations? @Apoptosis Karyorrhexis Coagulation necrosis Karyopyknosis Karyolysis # During embryogenesis the epithelial band also known as vestibular plate gives rise to development of vestibule of mouth. What biological mechanism of the programmed death of cells provides growth of buccolabial sulcus from epithelial plate? Necrosis @Apoptosis Amitosis Meiosis Paranecrosis # All of thefollowing are cellular responses to injury EXCEPT one: Cell death Cellular adaptation Intracellular accumulation @ Repair Reversible changes # Which of the following cellular changes represents is the best evidence for irreversible cellular injury: Epithelial dysplasia Cytoplasmic fatty metamorphosis @Nuclear pyknosis Date: 2016-03-03; view: 3691
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